DULUTH, Minn--Community physicians, at least in Minnesota, appear
to have the right attitude toward relieving pain in cancer patients
but may be deficient in specific areas of knowledge about cancer
pain management, say Thomas E. Elliott, MD, and his colleagues
with the Minnesota Cancer Pain Project (MCPP), a randomized community
trial testing innovative strategies to improve cancer pain management.
The researchers, from the University of Minnesota-Duluth, surveyed
physicians from six Minnesota cities to explore whether knowledge
deficits and inappropriate attitudes present barriers to optimal
cancer pain management, and also to provide a database for the
Fourteen basic concepts of cancer pain management were used to
formulate 15 knowledge items and 9 attitude items for the survey.
Of 145 physicians who responded to the survey (an 87% response
rate), the majority were primary care specialists (73%), with
surgeons representing 22%, and other subspecialists 5%.
Although the physicians' overall knowledge scores were fairly
high, with the mean falling within the best quartile of the possible
range, an analysis of specific survey items showed specific knowledge
deficits (that is, less than 50% of the physicians gave the desired
response, with a range of 12% to 48%) (J Pain Symptom Manage 10:494-504,
The survey found that more than 50% of physicians disagreed with
the following true statements:
1. Analgesic tolerance to opioids is not a problem.
2. Addiction risk is low in cancer pain patients.